Abstract: A self-propelled device for locomotion through a lumen, comprising a set of serially arranged inflatable chambers, and incorporating a number of novel aspects. To enable easy insertion and use, the rigidity of the device is increased by means of rigid inserts in the balloons, or by use of stiff springs between segments. The working channel can be attached to the distal chamber of the device, such that it is pulled from the leading end of the device during inflation, rather than being pulled from the trailing end of the device during deflation. Lumen wall inspection or treatment facilities are enabled by means of a camera or treatment arm mounted between two distally positioned balloons, the device is able to provide observation capabilities to the lumen wall, yet without becoming excessively dirty by exposure to the front end of the device, as in prior art camera units.

Abstract: Systems and methods for performing robotic endoscopic surgical procedures, according to a surgical plan prepared on a preoperative set of three dimensional images. The system comprises a surgical robot whose coordinate system is related to that of fluoroscope images generated intraoperatively, by using a three dimensional target having radio-opaque markers, attached in a predetermined manner to the robot or to another element to which the robot is attached, such as the spinal bridge or an attachment clamp. The robot is mounted directly or indirectly on a bone of the patient, thereby nullifying movement of the bone, or a bone tracking system may be utilized. The coordinate system of the intraoperative fluoroscope images may be related to the preoperative images, by comparing anatomical features between both image sets. This system and method enables the endoscope to be directed by the robot along the exact planned path, as determined by the surgeon.

Abstract: A miniature surgical robot is attached directly to the bone of a patient at a surgical site, thereby locating the robot precisely on the bone. Intraoperative two-dimensional images of the robot on the bone together with an image referencing element disposed in a predetermined position relative to the robot, are correlated to form a three dimensional image. One or more windows of this three dimensional image are registered with similarly located windows in a preoperative three-dimensional image of the surgical site, the preoperative image including details of the surgeon's plan. This registration of these windows defines the referencing element position in the preoperative image, and hence the robot location in the preoperative image. This enables the robot to be directed to pre-operative determined positions based on the pre-operative plan to perform a surgical procedure.

Abstract: A system and method for knee arthroplasty procedures, using a novel leg rotation fixture to enable the leg mechanical axis, the tibia and the femur to be mutually disposed such that the load bearing, mechanical axis of the leg runs through the center of the knee joint. A measurement gauge is provided for mounting on the tibia and for aligning a baseplate in a known position on the tibia. This baseplate supports an X-ray target plate in a known position relative to the tibia, used in determining the mechanical axis, and an optional surgical robot, used to perform tibial and femoral cuts. The position of the femur relative to the robot may be determined from X-ray imaging of the pelvic region after attachment to the baseplate of an additional target extending to the pelvic region. The system enables improvement in the accuracy of knee arthroplasty procedures.

Abstract: A drilling guide cannula, having a serrated distal end in the form of axially moveable teeth which enables all or most of the teeth to maintain biting contact with the bone surface, essentially independently of the curvature of the bone surface and the drilling angle. The cannula outer wall incorporates a number of pins arranged circumferentially around the drilling bore. These pins slide axially relative to the cannula, preferably in bored holes or in channels formed within the wall of the cannula. Each of the secondary pins has a sharpened distal end, each constituting a moveable tooth. The cannula is applied to the bone to be drilled at the desired drilling position and angle, and the pins are forced axially towards the bone surface. The pins take up the contour of the bone surface and each pin bites into the bone surface to rigidly position the drilling guide cannula.

Abstract: A self cleaning inlet head for use on a shunt. The head has a tube with openings disposed in predetermined positions in its wall, and a cleaning element installed inside the tube. The cleaning element may comprise a central shaft with a number of bristles protruding therefrom, preferably in locations substantially identical to the positions of the openings in the wall of the tube. Mutual vibratory motion between the cleaning element and the tube causes at least some of the bristles to enter the openings, thereby keeping them clear, and preventing tissue growth into them. The vibratory motion may be generated by the action of an external field on a responsive part of the cleaning element, such as an external magnetic field operating on a magnetic or magnetized part of the cleaning element or the bristles. Alternatively, the external field may be an ultrasound field operating on the bristles.

Abstract: An apparatus and method for assuring effective backup for sensor failure in robots, by utilizing a single extra sensor attached between the end actuator and the base. The single extra sensor provides absolute back-up for any single encoder failure that may occur in the system, and statistically significant back-up for any double encoder failure. A single additional sensor effectively provides the robotic system with one redundant information input to the robot control algorithm, which can be used in order to determine whether any of the other control sensors, or even the additional sensor itself, has failed and is delivering an erroneous reading, and hence to warn the operator of the failure. A single additional sensor also provides useful warning of the simultaneous failure of two sensors, since the likelihood that two sensors fail simultaneously in a mode that makes the failures undetectable, can be regarded as statistically insignificant.

Abstract: A self-propelled device for locomotion through a lumen, comprising a set of serially arranged inflatable chambers, and incorporating a number of novel aspects. To enable easy insertion and use, the rigidity of the device is increased by means of rigid inserts in the balloons, or by use of stiff springs between segments. The working channel can be attached to the distal chamber of the device, such that it is pulled from the leading end of the device during inflation, rather than being pulled from the trailing end of the device during deflation. Lumen wall inspection or treatment facilities are enabled by means of a camera or treatment arm mounted between two distally positioned balloons, the device is able to provide observation capabilities to the lumen wall, yet without becoming excessively dirty by exposure to the front end of the device, as in prior art camera units.

Abstract: A disposable endoscope body having an enclosure in its distal end for a non-disposable element, such as a video camera head. Because of its complexity and sensitivity, the camera head is non-disposable and cannot be sterilized. The camera head is sealed in the endoscope body, such that it does not contaminate the patient during the procedure. Sealing is achieved using an end cap. After use, the camera is withdrawn from the proximal end of the endoscope, which, being near to or within the workstation, has not been inserted into the subject and should be free of patient contamination. Passage of the camera out through the proximal end therefore avoids contamination by the patient, such that it can be used again without need for sterilization. A dispensing kit is described, for supplying the sterile endoscope body and for installing and sealing the camera with a minimum of manual intervention.

Abstract: A robotic system for steering a flexible needle during insertion into soft-tissue using imaging to determine the needle position. The control system calculates a needle tip trajectory that hits the desired target while avoiding potentially dangerous obstacles en route. Using an inverse kinematics algorithm, the maneuvers required of the needle base to cause the tip to follow this trajectory are calculated, such that the robot can perform controlled needle insertion. The insertion of a flexible needle into a deformable tissue is modeled as a linear beam supported by virtual springs, where the stiffness coefficients of the springs varies along the needle. The forward and inverse kinematics of the needle are solved analytically, enabling both path planning and correction in real-time. The needle shape is detected by image processing performed on fluoroscopic images. The stiffness properties of the tissue are calculated from the measured shape of the needle.

Abstract: A spinal intervertebral support implant, for fusion or for dynamic stabilization purposes. A rod, preferably in the form of a screw, is inserted obliquely from the pedicle of an inferior vertebra into the body of a neighboring superior vertebra, through the disc space. The rod can be anchored into the body of the superior vertebra by means of a force fit or a screw thread. A pile of elements is disposed on the rod in the disc space like a pile of washers, so that the compression load between vertebrae is carried partly by these elements. These elements can be inserted through the bore through which the rod was inserted in a tightly folded configuration, and deployed into their washer-like form only when in position in the intervertebral space, such that there is no need for any additional incisions.

Abstract: Endoscopic illumination and imaging systems for enabling observation of both the forward and rearward directions in a lumen using only a single imaging device. According to one implementation, the system utilizes the effects of a partially reflective mirror to respectively transmit and reflect light from the different portions of the lumen or cavity, and uses separate groups of illumination sources to illuminate one or the other section of the lumen, such that the illuminated section is preferentially imaged by virtue of its increased light level. In a second implementation, electrically switched mirrors are used, having properties switched between a transmissive and a partially reflective state, such that the mirror can be switched between imaging the regions forward of the camera when in a transmissive state, and imaging the regions rearward of the camera when in a reflective state. A mechanically swiveled mirror is described for the same purpose.

Abstract: An autonomous vibration-driven device, for motion through a lumen or along a surface, utilizing an array of flexible fibers attached to the body of the device. The outer surface of the fibers have an anisotropic coefficient of friction with the surface along which the device is to move, and the fibers extend from the device body such that at least some of the fibers are in contact with the walls along a part of their length. A transducer is used to vibrate the device, such that it moves down the lumen. The transducer can be either device borne or external. A rotary device is also described, utilizing an array of fibers disposed on the rotor's body, the fibers having an anisotropic coefficient of friction with a central stator or with an outer circular wall. A planar motion device is also described for crawling over a planar surface.

Abstract: A hand held robotic system that remains stiff so long as it is operating within allowed limits, but which become actively controlled once the operator exceeds those limits. The system thus corrects deviations by more than a predetermined amount of the operator's hand motions, so that the tool remains in the allowed region even when the operator's hand deviates from the planned trajectory. The pose and path of the robotic operating head is ascertained by means of a navigation or tracking system, or by means of a proximity device to measure the closeness of the operating head to a damage sensitive feature. As the tool deviates from its predetermined path or pose, or comes too close to the hazardous area, the robot control acts to move the tool back to its predetermined pose or path, or away from the hazardous region, independently of user's hand movement.

Abstract: A robotic system for performing minimally invasive spinal stabilization, using two screws inserted in oblique trajectories from an inferior vertebra pedicle into the adjacent superior vertebra body. The procedure is less traumatic than such procedures performed using open back surgery, by virtue of the robot used to guide the surgeon along a safe trajectory, avoiding damage to nerves surrounding the vertebrae. The robot arm is advantageous since no access is provided in a minimally invasive procedure for direct viewing of the operation site, and the accuracy required for oblique entry can readily be achieved only using robotic control. This robotic system also obviates the need for a large number of fluoroscope images to check drill insertion position relative to the surrounding nerves. Disc cleaning tools with flexible wire heads are also described. The drilling trajectory is determined by comparing fluoroscope images to preoperative images showing the planned path.

Abstract: An orthopedic screw having a thread with two parts, a distal and a proximal part, each having a different thread configuration. The distal section has a thread with outer dimension and pitch suitable for entry into cancellous bone, while the proximal section has a composite thread comprising (i) a first thread of the same or slightly larger outer diameter as the cancellous thread in the distal section, having the same pitch thereof, and lying on the same helix, and (ii) another thread having a smaller outer diameter but the same pitch as the first thread, but disposed on a helix displaced from that of the first thread, such that it lies between the crests of the first thread. This screw enables optimum fixation strength in a bone or bones having a harder cortical outer section and a softer cancellous inner section. The screw may have an unthreaded central section.

Abstract: Endoscopic illumination and imaging systems for enabling observation of both the forward and rearward directions in a lumen using only a single imaging device. According to one implementation, the system utilizes the effects of a partially reflective mirror to respectively transmit and reflect light from the different portions of the lumen or cavity, and uses separate groups of illumination sources to illuminate one or the other section of the lumen, such that the illuminated section is preferentially imaged by virtue of its increased light level. In a second implementation, electrically switched mirrors are used, having properties switched between a transmissive and a partially reflective state, such that the mirror can be switched between imaging the regions forward of the camera when in a transmissive state, and imaging the regions rearward of the camera when in a reflective state. A mechanically swiveled mirror is described for the same purpose.

Abstract: A robotic system for flexible needle steering under ultrasound imaging. A robot is used to steer the needle along a predetermined curved trajectory by maneuvering the needle base. The needle tip position is detected by an ultrasound sensor and the tracking error of the needle tip from a predetermined needle path is input to a controller which solves the inverse kinematic based on the needle position, and the needle and tissue properties. The control algorithm uses a novel method to detect the elastic properties of the tissue by analyzing tissue motion at the region in front of the needle tip. The inverse kinematic solution may be performed on a model of the needle as a flexible beam having laterally connected virtual springs to simulate lateral forces exerted by the tissue elasticity. The system is able to direct the needle to a target within the tissue while circumventing forbidden regions.

Abstract: A spinal intervertebral support implant, for fusion or for dynamic stabilization purposes. A rod, preferably in the form of a screw, is inserted obliquely from the pedicle of an inferior vertebra into the body of a neighboring superior vertebra, through the disc space. The rod can be anchored into the body of the superior vertebra by means of a force fit or a screw thread. A pile of elements is disposed on the rod in the disc space like a pile of washers, so that the compression load between vertebrae is carried partly by these elements. These elements can be inserted through the bore through which the rod was inserted in a tightly folded configuration, and deployed into their washer-like form only when in position in the intervertebral space, such that there is no need for any additional incisions.

Abstract: A framed device in the form of a bridge for fixing a number of vertebrae together into positions which are uniquely defined relative to the bridge, but which can move with the spine relative to the external environment. The fixation generated by such a bridge is especially useful in Computer Assisted Surgery procedures, either using manual navigation and a tracking system to follow the position of the surgeon's tools relative to the operated vertebrae, or by using a pre-programmed robot mounted on the bridge itself to perform the surgery. Alternative embodiments of the bridge may be used either for performing surgery in one procedure on a number of vertebrae of the spine, or as a reference frame for performing surgery at different locations along the spine, while providing an alignment reference along major lengths or along all of the spine.